Anaesthesia for foetal surgery

Anaesthesia for foetal surgery is one of the most exciting and challenging fields of anaesthesia. The anaesthetist is involved in the well being of two or more patients (mother and foetus or foetuses). Hysterotomy based procedures, Ex-utero intrapartum therapy (EXIT), minimally invasive foetoscopic procedures and micro-invasive image-guided procedures are done, utilizing placental support for foetal well being; while the mother can receive general anaesthesia, regional anaesthesia or local anaesthesia. Haemodynamic stability, vigilant monitoring, judicious fluid replacement, adequate maternal tocolysis, good intraoperative and postoperative analgesia are the anaesthetic goals. Ethical considerations for foetal surgery are like those involved in organ transplant, and should always be considered before planning such procedures, which involve multidisciplinary team work.